SCHEDULED DOWNTIME: We will be performing a database migration that will result in the site being unavailable for approximately 1 hour starting at UTC: Monday, 20 May 2024 11:00 PM (check your local time here

Intracholecystic papillary neoplasm

Last revised by Henry Knipe on 15 Feb 2023

Intracholecystic papillary neoplasms, previously known as intracystic/intraductal papillary tubular neoplasms 2, are rare, pre-invasive neoplasms of the gallbladder.

On imaging, these lesions resemble adenomas of the gallbladder or have features suspicious for gallbladder carcinoma, which usually lead to cholecystectomy and diagnosis. Given those non-specific imaging features, they should be reported and managed as per the gallbladder polyp guidelines

As the distinction of intracholecystic papillary neoplasms from gallbladder adenomas is not entirely clear, with important overlap between both entities, some authors have proposed that both conditions should be grouped under the same terminology 1. When an invasive component is present, the lesion is called intracholecystic papillary neoplasm with an associated invasive carcinoma 2.

Intracholecystic papillary neoplasms are rare, corresponding to ~0.5% of all gallbladder neoplasms ref. They are most frequent in women in their 6th decade of life 2

  • no association with gallstones 2

Most of the cases are asymptomatic, although right upper quadrant abdominal pain has been reported 2

Intracholecystic papillary neoplasms are tumors analogous to intraductal papillary neoplasms of the bile ducts (IPNB)intraductal papillary mucinous neoplasms (IPMN) of the pancreas and pancreatic intraductal tubulopapillary neoplasms (ITPN) 2

Adsay et al. have proposed that all gallbladder preinvasive adenomas over 1 cm should be grouped under the term ICPN 1

  • papillary or tubulopapillary patterns

  • high-grade dysplasia is frequent (up to 75% to 100%) 2

  • an invasive component is also prevalent (up to ~72%) 2

  • MUC1 expression is frequent 2

Although there are no large series in the literature to support an overall imaging pattern of these lesions, it is known that they present similar to large polyps, particularly adenomas, or to intraluminal masses suspicious for gallbladder carcinoma.  

Most cases, if not all, will be confirmed after surgery, as intracholecystic papillary neoplasms will be managed by the gallbladder polyps guidelines or based on the suspicion of adenocarcinoma of the gallbladder 2

Intracholecystic papillary neoplasm without an invasive component has a 5-year survival of ~80% and with an invasive component a 5-year survival rate of 60% 2. Intracholecystic papillary neoplasm with an invasive component has a better prognosis compared to conventional adenocarcinoma of the gallbladder 1

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.